December/January 2012/2013 (vol. 09/4)

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Research Plus

Job strain and heart disease

A meta-analysis of 13 cohort studies in seven western European countries found that job strain was significantly associated with a small but consistent increased risk of incident coronary heart disease (CHD) (hazard ratio = 1.23; 95% confidence interval (CI) 1·10–1·37). All studies were part of the IPD-Work research consortium established in 2008. Job strain was measured using the job-content and demand–control questionnaires, with CHD assessed largely from hospital admission and death registries. Data were available for 197,473 participants; 2,538 incident CHD events were recorded over an average of 7.5 years. The association remained after controlling for lifestyle risk factors, age, sex, and socioeconomic status. The population-attributable risk for job strain is calculated at just 3.4% – much lower than other risk factors, such as smoking (36%) and obesity (20%).


The Lancet 2012; 380: 1491–1497.


Occupational Health at Work December/January 2012/2013 (vol. 09/4) pp40